Organization Active NPI

Robert P Pereira PHD Inc

  • Clinical Psychologist
  • Birmingham, MI
National Provider Identifier
1174781462
Registry record updated Dec 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
RP005866 Issued in MI
Legal business name
ROBERT P PEREIRA PHD INC
Practice address
801 S Adams Rd Ste 200
Birmingham, MI 48009-7018
Phone
(248) 258-5064
NPI assigned
May 23, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Robert Pereira, PHDNPI 1992879142
Title
Owner
Phone
(248) 760-1797

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X RP005866 MI Primary

Addresses

Primary practice location

801 S Adams Rd Ste 200
Birmingham, MI 48009-7018

Mailing address

801 S Adams Rd Ste 200
Birmingham, MI 48009-7018
Phone (248) 760-1797

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080625000155 MI Part B Supplier - Clinic/Group Practice 7517038136 Receives reassigned benefits from 1 practitioner
Practice locations: Birmingham, MI; Sterling Heights, MI

National Provider Directory

National Provider Directory

Locations

801 S Adams Rd
Ste 200
Birmingham, MI 48009
Phone (248) 258-5064

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1211500800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1671494400000",
    "number": "1174781462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 S ADAMS RD STE 200",
            "city": "BIRMINGHAM",
            "state": "MI",
            "postal_code": "480097018",
            "telephone_number": "248-760-1797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 S ADAMS RD STE 200",
            "city": "BIRMINGHAM",
            "state": "MI",
            "postal_code": "480097018",
            "telephone_number": "248-258-5064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT P PEREIRA PHD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-23",
        "last_updated": "2022-12-20",
        "certification_date": "2022-12-20",
        "status": "A",
        "authorized_official_last_name": "PEREIRA",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "248-760-1797",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "RP005866",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Birmingham, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.